64 year old female with a history of seizures, hypertension, and osteoarthritis was diagnosed with a case of recurrent vaginal candidiasis. Her current medications included: Dilantin Enalapril Amlodipine Ibuprofen as needed Her previous labs were unremarkable with a total Dilantin (phenytoin) level of 16 and seizure free for well over a period of a year. She […]

78 year old patient recently on Dilantin (phenytoin) suspension had a seizure so a total Dilantin level was checked. (A free level probably would’ve been ideal in the case.) The level came back at around 4 which was unusual for this patient. Their normal total level was in the 12-14 range. All factors were being considered […]

98 y/o female had a long history of seizures was treated with Dilantin (phenytoin) 100 mg twice daily. The Dilantin level was routinely drawn every 6 months and had been in the 6-10 range for quite sometime (normal total level is 10-20, but there are multiple variables that can make the value less than accurate). The […]

Dilantin (phenytoin) is probably one of the dirtiest drugs, but is necessary as it treats an obviously serious condition (seizures). It has many clinical quirks that you need to be aware of. 72 year old female with a long history of seizures was on a maintainence dose of 200 mg twice daily. Seizures were well […]

69 year old male with significant respiratory issues including COPD – This patient was challenging, but did have the intent to quit smoking which was most certainly complicating his respiratory status. Other chronic conditions included: Coronary Artery Disease, Hypertension, Hypercholesterolemia, Seizures, and GERD. He has been diplaying signs/symptoms of depression of late, and the primary […]

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To whom much is given, much is expected. I’ve had a lot of really kind people help me along the way, and I wanted a way for myself and others to give back some of the things we’ve learned about medication management and healthcare. Good information from the front lines of healthcare is really hard to find, and that is what I try to provide day after day.